Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial
Abstract Background Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. Methods Health In Pregnancy and Postpartum (HIPP) was a rando...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | International Journal of Behavioral Nutrition and Physical Activity |
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| Online Access: | https://doi.org/10.1186/s12966-022-01387-w |
| _version_ | 1811302024935899136 |
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| author | Sara Wilcox Jihong Liu Gabrielle M. Turner-McGrievy Alycia K. Boutté Ellen Wingard |
| author_facet | Sara Wilcox Jihong Liu Gabrielle M. Turner-McGrievy Alycia K. Boutté Ellen Wingard |
| author_sort | Sara Wilcox |
| collection | DOAJ |
| description | Abstract Background Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. Methods Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain. Results Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain. Conclusions The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. Trial registration This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518 |
| first_indexed | 2024-04-13T07:19:15Z |
| format | Article |
| id | doaj.art-a477ab29cabb4ec381ef6b541314f0c4 |
| institution | Directory Open Access Journal |
| issn | 1479-5868 |
| language | English |
| last_indexed | 2024-04-13T07:19:15Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Behavioral Nutrition and Physical Activity |
| spelling | doaj.art-a477ab29cabb4ec381ef6b541314f0c42022-12-22T02:56:39ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682022-12-0119111310.1186/s12966-022-01387-wEffects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trialSara Wilcox0Jihong Liu1Gabrielle M. Turner-McGrievy2Alycia K. Boutté3Ellen Wingard4Prevention Research Center, Arnold School of Public Health, University of South CarolinaDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South CarolinaDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South CarolinaPrevention Research Center, Arnold School of Public Health, University of South CarolinaPrevention Research Center, Arnold School of Public Health, University of South CarolinaAbstract Background Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. Methods Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain. Results Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain. Conclusions The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. Trial registration This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518https://doi.org/10.1186/s12966-022-01387-wPregnancyMaternal healthHealth behaviorsBehavior changePhysical activityNutrition |
| spellingShingle | Sara Wilcox Jihong Liu Gabrielle M. Turner-McGrievy Alycia K. Boutté Ellen Wingard Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial International Journal of Behavioral Nutrition and Physical Activity Pregnancy Maternal health Health behaviors Behavior change Physical activity Nutrition |
| title | Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial |
| title_full | Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial |
| title_fullStr | Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial |
| title_full_unstemmed | Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial |
| title_short | Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial |
| title_sort | effects of a behavioral intervention on physical activity diet and health related quality of life in pregnant women with elevated weight results of the hipp randomized controlled trial |
| topic | Pregnancy Maternal health Health behaviors Behavior change Physical activity Nutrition |
| url | https://doi.org/10.1186/s12966-022-01387-w |
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